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Sarah Richardson: Hi, I'm Sarah Richardson, former CIO and President of the 229 Executive Development Community, with a passion for empowering others to reach their full potential. Welcome to Flourish, where we delve into captivating career origin stories, sparking conversations that inspire, inform, and foster a sense of community. Join us as we explore the journeys that have shaped successful professionals and uncover the insights that can help you thrive in your own career path.

Thanks for joining us.

Meet Karen Marie Joswick

Sarah Richardson: Welcome to today's episode of Flourish, our guest is Karen Marie Joswick. Karen is a dynamic leader in the healthcare industry, known for her expertise in value based care, strategic operations, and driving margin growth.

With a wealth of experience and a fresh perspective from recently starting her own company, Flourish Karen is at the forefront of transforming how healthcare organizations operate and deliver care. Not only is she a seasoned professional, but Karen is also deeply passionate about balancing the demands of running a business while maintaining a fulfilling personal life.

From navigating the complexities of healthcare to championing innovative solutions that enhance patient outcomes, Karen's journey is both motivating and insightful. Karen, welcome to the show.

Karen Joswick: Sarah, thank you so much for having me. It's great to see you.

Sarah Richardson: Great to see you as well. We're on two different coasts, but one of the things I love about curating content and curating conversations for Flourish is that we can be anywhere. It's really about the relationships we've developed over time and bringing that to the forefront.

So people appreciate that your network is vast. But the intentionality that you put into conversations and taking time for one another is really what makes a difference.

Karen Joswick: Yeah, I agree. And I love the fact that you highlighted we're East Coast, West Coast today. So that's great.

Sarah Richardson: Yeah. So your day's almost done and mine's probably halfway finished.

So there'll be in the universe that we live in. And that's one of the things we'll talk about when you work from home or you work for yourself. It's a different experience than when you go into an office every day. And that's a real dynamic. We obviously deal with, with our clients and with our relationships that we have in this industry,

you've made so many amazing decisions in your career about whether it's career change, personal growth. One of the things I always review when I interview someone on Flourish, even if I know them very well and you know, I've known each other for a while, is their LinkedIn profile. And you had long 10 years at organizations and now you've just taken this dynamic leap into all kinds of different perspectives.

Karen's Career Journey and Insights

Sarah Richardson: And so when you think about having made a recent career change and a significant one at that, What inspired you to take this bold step in your career, and how has your network supported you through this transition?

Karen Joswick: You know, Sarah, it's funny. I don't feel like it was that big of a step. But when you say it like that, I guess maybe it is for many. It really came from a deep rooted passion for wanting to see change in healthcare and having been part of organizations for a long time and experiencing different parts of the healthcare specter.

And knowing that it. I can make a bigger difference and help impact in a bigger way. And so there was a deep rooted passion really was the inspiration and saying like, I want to, I want to change this. And part of the driver of me on a personal level being, you know, a mom and a daughter and a wife and watching and experiencing the healthcare system and, and also knowing that there's more to give and more to be elevated and changed in healthcare.

My network's been amazing surprisingly so, and in some ways not surprising, right? There have been people from all over that I've worked with a decade ago that I was able to reconnect with through this journey, which has been amazing. And then some of my closest supporters have been wonderful cheerleaders, really, you know, connecting me in, whether it's emotional support of keep doing it, keep your head down, you know, stay focused, or, you know, It's been people, you know, who've been able to make introductions or connections that maybe I didn't have or help connect dots that I wasn't.

So I really feel very grateful and I think that Part of the early success that I've been able to experience has been because of that investment in that network and that partnership that I was able to kind of really take off where I have.

Sarah Richardson: You mentioned that in the planning implementation that it takes to make this happen and about your network.

Tell us a bit about what you are now doing and how you decided on that becoming the initial value proposition that you shared with your network when you made the change.

Karen Joswick: it's a unique opportunity that really a lot of health, so every healthcare organization is being met with unique challenges. The payment model is changing across the United States.

It doesn't matter whether you're talking about Medicare, Medicaid, commercial, everyone's payment structure is changing. And with that, there's all of these other market conditions that are driving necessary restructure that's happening across the country. And the researchers happening in the way that care is being delivered, how, when, who, the role that technology is having.

And in order to do all of that, you need to have, individuals and leaders and experts that are, , able to help wrap their arms around organizations and help support them, navigate through those changes. I've been fortunate that I worked in some organizations that were pretty progressive in the work around value based care, which has allowed me to gain some great experience, but it was, it was really this, call to action, if you will, from even some of my network to say, we really need people like this.

We, we wish there were more support opportunities in, in the market. And that's really what drove the, you know, the launch of Benevolence.

Sarah Richardson: I bet you're finding, which is always so fascinating about being able to focus on a singular or a Smaller batch of disciplines at any given time, when you work within the system, you get pulled in so many directions.

It's hard to be able to create the focus and the ability to do something exceptionally well. We can be good at a lot of things, but really to really deliver on one to two or three things at a time. Now that you have your own organization and you see the challenges and the changes that healthcare needs, when you think about how you can address these evolving needs in innovative ways.

What is proving to be true right now?

Challenges and Innovations in Healthcare

Karen Joswick: You know, it's all of those challenges that I talked about that the health care organizations are experiencing, whether it's around revenue cycle or workforce. You know, workforce is something that keeps everyone up at night and how they really evaluate and help engage their staff in meaningful ways to make these changes.

What I think is one of the most exciting opportunities is how organizations are approaching these challenges. And it's not necessarily the nuts and bolts around how you implement a payment model or how you launch a new piece of technology. It's the How you engage your team, how do you build teams of people to do this work?

And that's where there's some secret sauce. When you have the ability to take these market changes, take the rapid use of technology and the new, new tools that are coming out, which we can spend some time talking about and what that means to the market. And then really apply it to a unique environment, a culture with a team that requires a different level of leadership.

And that's often where I'm getting, calls to say, how would you, or where have you, or what are your thoughts about? It doesn't mean I'm always right, but I think sometimes that sounding board is really what people are looking for to just kind of validate that they're not alone and that there's challenges and you need people who have either been there, done that, or people who are just willing to listen to you.

And I think that that to me is one of the greatest gifts that we can offer out to other leaders is the ability to listen and help support.

Sarah Richardson: Well, plus you're able to see things from myriad perspectives now as well. You're looking at multiple organizations and being able to adapt. And we all know healthcare is local.

We talk about that often, but these changing needs, some of the strategies that you need to implement to align with a C suite perspective, their expectations, strategic forecasting, all But ultimately, being able to tell that story in a way that resonates so that progress can be made. What does that look like from where you are today?

Karen Joswick: You know, it's funny, I've spent most of my career in the provider space, right? Worked in provider organizations. And now the work that we do is not just provider focused. We work with payers, we work with digital health companies. Really, we work across the entire continuum. And what I think has been really most fun, I would say, is helping connect dots cross sector.

So there's definitely these presumptions on either side of payers or providers or tech companies about what the other sectors are looking for or their needs are. And sometimes they're right and other times they're not right. And so I really have liked being able to, to share those nuggets, those little pearls of wisdom to Actually, this is what I'm hearing from other parts of the industry, and it's an opportunity that I really haven't had as much in my career because I've been so focused on just the provider space and now being able to connect in with providers and payer and, you know, solution companies, it's really been refreshing to kind of help connect those, but Sarah, it's mostly, the biggest thing is being adaptable.

And being flexible in the work and understanding that how you're going to make movement on these headwinds as an organization is being adaptable. And really, as a firm, that's our goal too, is to be, you know, to be adaptable and support our clients. And sometimes what is presented as a need is not always what the end project becomes, because it evolves and it changes, and you pull the thread and you realize more things unraveled.

Sarah Richardson: Well, all of it involves a level of risk. You and I have chatted often. We talk about either advice or perspectives that we receive about taking risks and learning from failures. That's going to be personal or professional, especially as you learn more about organizations, that desire to meet them where they are, but needing to get them to a space where maybe they've never been, can you elaborate on some of the key lessons you've learned from your experiences personally and professionally about what it means to take risk and be comfortable, quote unquote, failing so that it leads to a greater success?

Karen Joswick: Yeah, absolutely. Comfortable failing, right? Every personality deals with that, but that's a hard, that's a hard thing to say. Be comfortable with failing, right? So I believe there's a, there's a lesson to be learned around calculated risk taking. So I gained a nickname many years ago of conservative Karen, right?

It was very conservative in my approach, whether it was implementing technology or, you know, You know, risk contract negotiations. I was, I was sometimes teased, right, you know, in a loving way of just being very conservative. But I think there's, there's, you know, some calculated risk that we all take in any career change, right?

Anytime you leave an organization and go, you're always, there's always risk. Anytime you move into a new role or you get, you take on a new team or you get promoted or, You decide to, you know, take on a second job or whatever it may be. There's always some sort of calculated risk and balancing that personal, professional spectrum.

But specific to kind of taking on risk in your profession, the key is, I think, really to be resilient and understand that at the end of the day if you are focused on the right things, if you are focused on the people and you are focused on trying to make a difference and do right, that everything else will come out in the end, right?

Everything will come out in a way. And so that kind of calculated risk taking to me, professionally and personally, is okay. And it's something that took a lot of time. It took prayer, right? It took guidance. It took, you know, solitude to really reflect and say, I'm ready to make this leap because Even if I'm not as successful as I want to be or otherwise, I know my heart and the actions I took were in the right place.

But that took some courage, right, to be feeling resilient and to know that that's my goal,

Sarah Richardson: well, I love that you mentioned getting the comfortable failures, but the resilience factor, Being really, really key and forgiving ourselves for those moments when you're like, I call them oops, like how big the oops is can really be a component of how well you balance back.

But again, resilience is everywhere, whether that's in our cyber profiles, whether that's in our career profiles, the ability to really think about reinvention, having a strong network. and having backup plans. So when you think about how you approach this in the rapidly changing landscape of healthcare, what are some of those core conversations with clients like today?

Karen Joswick: With clients, it's interesting the conversations that they'll have sometimes is tell me your experience with, and then often the conversation is less about the experience and it's a Oh, you have the right kind of mentality and approach to this problem. And so often they're looking for a good partner.

They're looking for someone that they can trust and someone that's going to be honest with them. And so when I think about where there's an opportunity to really change healthcare, it's in the relationships and the partnerships that you develop and you create, that you, you know, invest in, it's also about.

Investing in yourself to some extent, right? Continuously learning and understanding what role or where you have gaps in knowledge or skill set, you know, constantly kind of taking a step back and saying, did I handle that the right way? Is there something that I could have done better? Do I need to learn more about it?

this topic. And so I think that to me has been really important through this journey. It's always been part of my career journey, but even more so because the stakes feel a little different this time, right? The stakes feel a little different, and it's exciting to, to be able to have the opportunity.

And I hope I don't fail, but if I do, I know where my heart is. And I think that that's like the greatest thing of this whole journey.

Sarah Richardson: Well, that whole concept of that backup plan. And so I'm actually, my next article is about your identity and your career and these different perspectives, because too often we get locked into one thing, and we don't realize how adaptable we are in other environments.

And so to your point, you're like, hey, I'm doing my own thing right now.

Personal Reflections and Future Vision

Sarah Richardson: And If it doesn't work, I have the option of the choice to go back to X, Y, or Z. What I'm curious about though, is now that you've had this sense of autonomy in the role that you have today, and you've worked for major corporations and health systems in the past, if you were to go back to something, for whatever reason it may be, what would be most enticing today?

And the reason I tee the question up the way that I do is that you and I both love organizational transformation. Driving change, making things happen. Sometimes it's positive, sometimes it's negative. But as you think about what you would be willing to go back to, how do you maintain that compassion and sense of purpose for work when you're having those conversations with clients, when you're also evaluating it for yourself?

Karen Joswick: Yeah, you know, maintaining compassion is something that regardless of who your employer is, you know, is such a core skill set. And it goes back to being that connected person, right? To be able to, you know, would you be my friend? And that relationship that you build with people is so important. When I think about going back into, you know, a corporate structure, if you will, you know, that's a little different than what I'm operating now.

I'm not necessarily opposed to that, but it's something that as I think about what that journey would look like, it would really need to be something that challenges and stretches me in ways that I haven't been or allows me to move forward on a mission that's exciting and something that I can have passion behind.

For me, as I've gotten into my career and now having done this work that's so mission and passion focused, I really want to continue feeding that passion. And so I want to be in an organization and a role that's Focused on putting the patient at the center of the work that we do that is focused on driving change and making healthcare more affordable improving quality, and I think that those are the kind of the true norths, if you will, Sarah, that I would need to find in an organization and that right now I've been able to create in my own circle but have also had the benefit of being able to be selective about who I partner with, frankly, right? And so I'm able to pick those organizations. The people that I'm working with share those same values. They worry about the cost of care and they want to figure out how we take all of this really great digital tech, artificial intelligence, and machine learning, and, you know, the list goes on, and weave it into a healthcare system that becomes more affordable for patients and still has great quality.

And that to me is the really exciting position that I'm in is I kind of get to pick who I'm partnering with to some extent, which is fun.

Sarah Richardson: It is fun. And to your point, if you do the intake or the discovery session with a client, And the outcomes of the mission and vision that they have for themselves is different than what you can or want to deliver.

There's a polite, no thank you. And it doesn't really tarnish your relationship because I got to believe that if it's not the right fit for you, you know to whom to refer them to still have their needs met.

Karen Joswick: Absolutely. And I think that honesty and integrity is the most important thing you can give to anyone.

You can be kind and honest. And I'm still as invested in helping people grow, whether I do the work for them or not. And the great thing about our networks, right, Sarah, is, you know, is the ability to say, Hey, I may not be the right person, but let's connect you with, or have you read and I love as I'm reading articles, if I find out something new, I'll send on to people who have even said to me, Hey, Karen, now is not the right time.

Can I send you stuff? So if I see an article in the Wall Street Journal, I'll send it to them. And they've loved that. Because you're thinking of the people. And it just goes back to the approach of the business. It's about the people first.

Sarah Richardson: It is. And it's amazing how simple acts of either thoughtfulness or kindness or intentionality don't cost you anything.

And the return on that, maybe you're sending an article to a proposed client. Maybe you're sending it to a friend you haven't talked to in a while, but you know that that's happening in their universe. You're already consuming or experiencing that data. To share it thoughtfully with another person doesn't take that much time to do it.

And it makes a difference. It matters to people when they know you've been thinking about them personally.

Karen Joswick: Absolutely. And it's something that I've experienced it pays dividends, as the receiver and as the giver, right, as someone who has been the recipient of people who have thought of me along their journey and said, Hey, Karen, did you think about this?

Or would you like to know this? And being able to pay that forward in the same regard is incredibly valuable. And brings this, you know, warmth that you can't explain.

Sarah Richardson: It does. One of my closest friends was a referral from a friend that I'd called about a scenario I was looking to solve in a lifetime about 15 years ago.

I said, Hey, I need help with this. And she's like, Hmm, I'm not the right person yet. Let me refer you to so and so. That so and so literally is in my inner circle now. And we're still friends with the other person who referred. And yet that flywheel, it's pretty powerful because to your point, When you like somebody and you trust them, you want to do business with them or you want other people to do business with them.

And it rarely doesn't come back to you in some form that is meaningful or makes a difference. But what's interesting most is this whole space of innovation and cost and margin. I believe more than ever. The conversations I'm having with CIOs and practitioners out there is about the financial resilience, about how to drive cost out, how to increase efficiencies.

And some of the technologies are fluffy and could be meaningful, but other ones are more about some of the brass tacks, workflow, physicians being able to spend more time with the patient, etc. What are your thoughts on the future of health systems and the technology? innovation, and most specifically, what are you excited about?

Karen Joswick: What I'm probably most excited about, and this may sound a little cliche, is some of the opportunities around artificial intelligence and machine learning.

And I know it's the hubbub, I know it's the conversation, I know there's lots of companies that we say are going to fail, and I get all of that. But when I think back to my goal around changing healthcare and making it more efficient, cost savings, quality improvement, we know that our fixed costs to run a health system, to run a plan, have got to change.

And the only way I see that happening is not necessarily laying off your workforce. That's not going to solve everything, right? And, you need to think about how you can, you know, be more efficient. And I think that's where there's some promise around. You know, some of these mundane tasks that we know we can automate and, you know, use robotics to be more efficient and to then take those tasks off of the humans, the people, and invest in the people.

And that's where I think you get back to the concept around patient centered care and investing in your workforce to make sure that we're dealing with workforce challenges. And so when I think about how this technology is coming in, my excitedness, my energy, my passion is really to see that artificial intelligence and machine learning and all of the aspects that we're seeing around other uses of tech really bend the cost curve in some way and not add more expense to health systems.

And I think that's a risk, right? I think there's a risk that You know, we get more technology and, you know, think about what the budget of an IT department was 10 years ago and what the budget of an IT department is now, right? The amount of cost that we keep adding and stacking on doesn't allow health systems or any healthcare organization to be successful.

So we've got to find some balance around the cost of tech and the value of tech and how it helps reduce the cost in healthcare. You know, and when I say cost, I mean like big So, those are the areas that I get really excited about, and then you know, I'm a policy wonk at heart, Sarah, and there's a lot of things that, you know, we need to deal with as a healthcare system.

You know, we think about telehealth and how amazing telehealth's prominent. And how much telehealth is now reverted back, largely because of some of the policies that are in play. I think about the challenges that we have around licensing and state rules. And I think that those barriers that we have in policy are creating challenges for adoption of more tech.

So. Those are the things that get me excited when I, when I really think about how tech could change healthcare, help us get there around value based care, but understanding that it takes a big team. We need some help. We need some help. It's bigger than just providers and payers.

Sarah Richardson: And as I always do believe, most things start at the policy level, because if it's mandated or it's regulatory or compliance, it's going to get done.

It'll be moved to the top of the governance list, the top of the pile of things that need to happen. They don't always bring out the impacts from a revenue generation perspective. In fact, some of the initial aspects of these regulations take more time, take more money. They don't necessarily make it better.

The intent to make it better is the longer term realization. And Whether we're using these different algorithms, whether it's your own data or external data, it's got to be something, again, that you can trust, that the modeling is making sense. And it doesn't have to start with these. Every company's going to tell you, Hey, we use AI ML.

I'm like, show me where it's working most effectively. And some of those initial entry points are things like the process automation, like the chatbots, like the ability to automate your testing and areas where The human doesn't necessarily get removed. The human gets reallocated in a way that allows them to do work that wasn't getting done before or had open head count vacancies.

And so much of the cost of care today still is about staffing costs and modeling in the clinical areas. And everybody has to take a piece of that pie back to be able to, Go towards the mission of the organization. So if IT has to take a little bit of a haircut so that there can be the right staffing levels in the clinical setting, what types of technologies get applied against that, and that goes back into, are you providing fee for service, value based care, different accountable models?

It, it is an ecosystem that is all coexisting at the same time. That CIO today has to bring that story forward in a way that talks about the business and operations and continuity, not necessarily about the technology.

Karen Joswick: Agreed, Sarah. And just to throw a little more curveball, where's the ethics in applying all of this technology and the health equity and this work?

And so if, you know, it isn't challenging enough to think about finances and clinical operations and tech, let's throw in legal and compliance and health equity at the same time, right? But that's the burden that's on people's shoulders today. And I think that's. You know, I want to be positive and think challenges are really opportunities.

And so that's where we like to partner with people.

Sarah Richardson: Well, one of the things too, that you have found and we've talked about is. Sort of unexpected lessons learned in early stages of a company. So you see things from very broad perspectives because you're not working one on one anymore. You're working with myriad companies, but when you think about starting a new company and how you see things shaping your long term vision, what does that look like and how important it is?

to believe in yourself and how this has influenced your success. What have been the driving factors for you that said, I made the right decision, I know I'm on the right track, and here's how I can provide the most value to my clients? Yeah,

Karen Joswick: well, self belief is really an important, I think when you embark on a journey that, you know, in some ways feels lonely and other times you feel like you have a crowd of cheerleaders that are just rooting you on, which is a wonderful feeling.

Self belief has been really important. And. Knowing that the work that we're doing and standing by the vision around why I launched this has been really important. Understanding that there's still some skeptics out there, right? And that's okay because sometimes those make you more energized to, to fight harder and to be really more focused.

But I think self belief is something that, is really dare I say contagious because what I have found when I partner with an organization and I bring energy and excitement around the work and what they're trying to accomplish, they instantly feed off of that energy. They get excited too, like, okay, yeah, we can do this and let's put pen to paper.

And I feel like that, that's part of the job. That's part of the brand. That's part of the, we're going to roll up our sleeves and sit in the trench with you. And. That has only come from self belief and that self belief was fed by, you know, my team, right? That team of people who have just cheered me on along personally and professionally.

The, the one unexpected lesson that I would say is the importance of flexibility. Oh my goodness. You know, it's so funny how, You can go out and survey the market and feel like you have a good understanding of what the needs are, and then you can get into a meeting or a conversation and find out that that is not at all what is needed or requested whatsoever, that really the ask is this and not this, right?

Or vice versa, the ask is much bigger and then than what was originally brought forward. And I think, My prior experience helped prepare me for that, not only to be flexible, but to be able to kind of sit back and say, with an analytical mindset, actually, you don't need X, you need Y and Z. And so if I can help, great.

If I can't, you know, to the earlier conversation, we try and help find, you know, help for other people. But flexibility is so important. Understanding that what's relevant today may not be relevant tomorrow. And it has changed. My goodness, look at everything that's happened in healthcare in the last couple of weeks, right?

So that alone, you know, it changes the demands and what people are calling and asking for.

Sarah Richardson: It absolutely does. And so you have to build a partnership, a relationship with every single client, whether it's acquisition or during, and even the after effects of all of that. What are some of the strategies that work best?

And we talked about people liking you, people trusting you, utilizing your network, but you get into the brass tacks of like, this is what it takes to run your own company. Hey, and by the way, I want to throw in the lens for those listening. You leave a corporate job that you're well compensated, great at doing, Probably predictable to a degree.

You have five kids and a, and a marriage and a life and all these other aspects, like bringing all these pieces together, you know, into, you know, we started talking about putting a bow on something, but how do you maintain that? That's strength to be able to say I'm doing this. And the reason I know I'm going to be successful is these are the relationships, or these are the ways that I am treating my clients.

What are some of those secret sauce components that people listening would say, I really want to do my own thing, but I have a mortgage and kids and a spouse and XYZ, like how do you do it?

Karen Joswick: Well, again, I mean, I have a great team, right? But I think the most important thing is being genuine in the relationships that you have with people, Sarah.

You've just got to be genuine. They, people see through it, if you're not genuine. And so, Anyone who's worked with me knows that I will talk about my kids and the fact that we were at a soccer field one weekend or that we're trying to balance or that, you know, I made a really bad batch of spaghetti sauce last night and my kids were upset and they want Chick fil A.

And people who've worked with me know that, you know, that I will be honest. And that could be a weakness or a strength depending on, you know, the person. But I think that that integrity for me is one of the most important ingredients that I've had throughout my entire career. Active listening, being consistent with the follow up and having that integrity.

You know, people know the quality of my work, which has been able to make, you know, when I've reached out to people, easier. People who have worked with me know what they get. I, Focused and work really hard for high quality work. So I think that that to me has been the, some of the most important things.

It's just being a genuine person and being dare I say authentic. Maybe to the point that, you know, people know my kids will eat fast food if I need to sometimes. And, that's okay, but I'm also happy to take days off when I need to, to, to be with them, so.

Sarah Richardson: I keep having to get props for Chick fil A.

I mean, yeah, it's fast food, but Chick fil A is almost like this, like, beacon. It's like In N Out Burger, which I would actually probably put Chick fil A as a healthier alternative, although here I am the person who in college drove two hours to get an In N Out Burger because there wasn't one that close, and then once it became to town, finally, I never went.

I think it was the scarcity perspective of it. You're right though, the genuine authenticity, like, life is not perfect all of the time. Things happen in any given moment. It's how you're rebounding, how you're addressing it. When people see that behind the scenes, All these other things are happening. To a degree, I do believe it puts people at ease because they feel like you're relatable as well.

It's like, Oh, perfect. Karen always looks amazing, always has the right answer, always has the perfect deck, always has the best story. Hey, guess what? And her car is, you know, Maybe there was ketchup smeared all over the back seat because they were fed, but you don't really know what happened back there in the interim.

And those are the moments that truly draw people together. It's the, it's the real life aspects of what we go through every day that create those lasting bonds.

Karen Joswick: Absolutely. And I find that those are the great conversations when I think about my network and the people that I have done business with, and look for.

It's the people who you can relate to. I mean, I had the ability just the other day to talk to someone whose child was also starting college and such a relatable time and season of life. And I think that when you're genuine and You are consistent in being that genuine and authentic person. There's a level of credibility that I do think is gained in that way.

Sarah Richardson: It'd be like a speedrun question of like, what did you feed your kids last night? Chick fil A, like, okay, you win. You're right though, that the kids going off to college every time I'm talking to mostly people in our age group, we don't have to define, of course, everyone knows I just turned 50 because I advertised it everywhere for fundraising.

When you do your job, your kids leave. And yet that's one of the hardest transitions in life. It's like, I say, Hey, good job, mom. Good job, dad. And I said that the other day to somebody and they just started crying. I said, this is like the best job I ever did. And it was like, I kind of wish that I hadn't done such a good job.

I wish community college was actually more enticing because they really weren't quite ready for their. For their kids to go off to college and yet, checkmark win. Like, hey, that was the intent, and it happened. And so sometimes when you do your best work, it's a bittersweet ending for sure, or a beginning in some cases, but it's hard.

It's hard when they leave.

Karen Joswick: Absolutely. No, absolutely.

Sarah Richardson: All right, we are going to do Speed Round though. These are some of the, you can answer one word, two words, three words, but we're jumping to Speed Round. The first question for you, what's the most unusual or unexpected challenge you face in starting your new company?

Karen Joswick: It's the variety of tasks. Right? So strategic planning and then I'm like working on my website. It is the spectrum.

Sarah Richardson: And it's all you. That's the thing too. It's like you don't get to just dish out some of these things to other people. You're like, oh yeah, I get to go update my website and I get to do this plan and I get to go have this call.

It's gear switching in a context that is probably just, it's foreign, but not impossible.

Karen Joswick: Yeah. It's very different. It's required different parts of my brain for sure.

Sarah Richardson: Yeah, you have to learn when you're like, Daniel Pink, The Owl and The Lark, like what time of day do you do your best type of work so that you know, like, oh, website updates, that's after dinner, after the kids are in bed, kind of a thing.

Karen Joswick: It's quiet and I can focus.

Sarah Richardson: Quiet. If you could instantly implement one innovation in healthcare, what would it be?

Karen Joswick: Oh, how about, this will get people excited. A universal, interoperable platform that meets all of the privacy requirements, right? But allows for health information to be exchanged. Just exchanged.

Sarah Richardson: That's it. If you listen to Bill this morning, or on This Week Health, the, the new data governance at the federal level that really does allow for all of the data interoperability to be the same, and it's in that, in that mode of getting released, and eventually that could actually be a thing where your information is just exchanged in a way that it can be available anytime, anywhere.

You're right though, we're not there yet. And the proof in the pudding will be. Hey, I just had to go to a specialist, or I had to go out of network, or whatever happened. Can I get that information to that provider without it being a completely separate task unto itself?

Karen Joswick: Absolutely. Kids to adulthood, adult to, I mean, it is just.

We could have a whole session on that, but that would be my if I had to dream, that would be one, that'd be a big one.

Sarah Richardson: All of your data is in one place. Yeah. Imagine that. What's your go to strategy for staying motivated and focused amidst a hectic world of healthcare operations?

Karen Joswick: Feeling comfortable to pause, right?

And reflect and celebrating small wins because the small wins eventually become the big wins. So celebrating small wins. Good.

Sarah Richardson: The thing about celebrating the small wins and even recording them, I used to tell my teams this. Number one, it allows your either mid year or end of year evaluation to essentially write itself.

And if you don't record the small wins, you will forget about them. So when you look back and you're having a bad week or a bad month or whatever's happening, you go back and you look at all those small wins. You're like, yep, I did make a difference. Maybe not today, but in general. I have made a difference in the things that I'm doing, so I love that advice.

This is going to be a tough one because you have to do it in one word. If you had to describe your approach to value based care, what would it be?

Karen Joswick: Collaborative. You need a whole team. It can't be done just by Karen or, or by the team that we bring. It has to be everyone at the table. They've got to be engaged. And organizations that are doing it really well, it's woven into the culture. It's in the fabric. So it

Sarah Richardson: can't just be an idea that gets tossed to Karen, the consultant with the organization that focuses on this.

It actually takes the culture of the organization wanting to make a significant difference in the way they operate their business every day.

Karen Joswick: Absolutely. And culture changes takes leadership, and that requires a deep rooted, Processes, changes, and investment in their teams and grassroots work. Yeah.

Sarah Richardson: That's why, when we think about that organizational change management aspect to how we tell the story, how we influence, et cetera, it really does come down to that.

I always tell people technology is already there. If you can get the people and the processes aligned, it's amazing what can happen if you really are committed to that being your North star. Absolutely. Yeah.

Karen Joswick: It can't just be something that's on a scorecard. No,

Sarah Richardson: because then

Karen Joswick: it's

Sarah Richardson: just one more thing on a scorecard.

Karen Joswick: We got lots of scorecards in healthcare.

Sarah Richardson: A lot of scorecards. Really, a funny true story is we had a scorecard in a previous lifetime. It took longer to produce the monthly scorecard because there were so many metrics than it did to take action on any one of them. And I thought, I can't make it up, 220 things

Karen Joswick: on a scorecard.

I believe it. I believe it. I believe it. Or tracking goals that really don't move and advance the organization's mission forward. Which is why we bring

Sarah Richardson: you into the picture because you can focus on one, two or three of those things at one time. And ideally the lead behind is something that they can sustain, which is one of the reasons I've always been drawn to your leadership style.

The things that you do is not only do you create and implement it, you give them time to let it bake in. So it becomes a part of the routine that they do every single day. That's how they get good at it. They keep doing it.

Karen Joswick: I I'm one person and you need this to be a bigger movement. So you need to be able to have skills that are sustainable for other people to take on and do.

Yeah. Invest in the people always.

Sarah Richardson: Which can be hard. It's hard for people to let go of things that they may be really good at, because that's a sense of their identity. And so when you can also help them figure out how to transition to something new and different, or add to that dossier, wow, what an impact that it makes.

Karen Joswick: Yeah,

Sarah Richardson: in a big way. Karen, thank you for being on the show today. What I love about Not just our professional relationship, but our friendship over these years is that we talk about real things that happen, things that happen at home, things that happen in our careers, things that happen with changes.

Cause you and I collectively have probably had five or six changes in our careers since we first met. And yet here we are. Always moving forward, always making a difference. So I can't thank you enough for not only being courageous and showing us the art of the possible and what can be done, but also the realistic aspects of what it takes to make a significant change in your life and your career.

Karen Joswick: Oh, Sarah, thank you. But really it's a highlight to you for investing in the community. I mean, when you have the ability to pull people together and rally around kind of leadership development and investing in people, that's really What's exciting about the work that you're doing. So thanks for doing that.

Sarah Richardson: Yep. We'll talk again. And thank you again for being on the show.

Karen Joswick: Thank you.

Sarah Richardson: Thanks for tuning in to Flourish, where we unearth the hidden gems of career journeys, illuminating paths to success and fulfillment. If you found value in today's conversation, please share it with your peers and leave us a rating and review wherever you listen to podcasts. We hope these stories are a catalyst of inspiration within you, propelling you forward in your own career odyssey.

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